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New Jersey rates for HCPCS A5114

Leg Strap; Foam Or Fabric Replacement Only Per Set (Special Coverage Instructions Apply. See Mcm: 2130)

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$6.10 / $6.10 / $6.10
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3.83 / $6.10 / $8.91
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$4.95 / $7.51 / $7.51
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$6.38 / $6.38 / $8.58
Emblem Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$11.43 / $11.50 / $16.38
Horizon BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$4.23 / $8.32 / $8.32
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$5.00 / $6.24 / $11.49